[Note: The full text of this article is available free here. ‘Indirect costs’ are the value of the patient's lost earning ability and unpaid caregiver time. ‘Direct costs’ are costs of health resources used. According to these data the median yearly total cost of FM ranges from $9,452 for mildly affected patients and $10,520 for moderately affected individuals to $16,276 for severely affected cases.]

Abstract: Background: Patients with fibromyalgia report persistent widespread pain, fatigue, and substantial functional limitations, which may lead to high health resource use (HRU) and lost productivity. Previous analyses of the U.S. population have not examined the direct and indirect costs of fibromyalgia by severity level.

Objectives: To assess:

a) HRU, direct and indirect costs associated with fibromyalgia in routine clinical practice in the United States using a patient-centric approach, and

b) The relationship of fibromyalgia severity level to HRU and costs.

Methods:

This study recruited a nonprobability convenience sample of 203 subjects aged 18 through 65 years between August 2008 and February 2009 from 20 U.S. community-based physician offices.

Subjects had a prior diagnosis of fibromyalgia by a rheumatologist, neurologist, or pain specialist; received treatment at the enrolling physician's practice for at least 3 months; experienced widespread pain for at least 3 months; and experienced pain in the previous 24 hours.

The 20-item Fibromyalgia Impact Questionnaire total score was used to stratify subjects into fibromyalgia severity groups:

• 0 to less than 39 = mild,

• 39 to less than 59 = moderate,

• 59 to 100 = severe.

Staff at each site recorded clinical characteristics, health resource use (HRU), and medication use attributable to fibromyalgia on a paper clinical case report form (CRF) based on a 3-month retrospective medical chart review.

Unit costs for 2009 were assigned to the 3-month HRU data reported on the CRF and 4-week subject-reported lost productivity.

Costs were then annualized and reported in the following categories:

• Direct medical,

• Direct nonmedical,

• And indirect.

Differences across severity levels were evaluated using the Kruskal-Wallis test (continuous measures) and Pearson chi-square or Fisher's exact tests (categorical measures) at the 0.05 alpha level.

Results:

Of the 203 subjects, 21 (10.3%) had mild, 49 (24.1%) had moderate, and 133 (65.5%) had severe fibromyalgia.

For subjects with mild, moderate, and severe fibromyalgia, respectively:

it took a study to figure out those with severe FM pay more than those without mild and moderate - that is pretty obvious. cmon, can we not spend our research money on better studies like trying to pin down the actual pathology/dysfunction of this disease so we can better treat it as right now current treatment is pathetic

it took a study to figure out those with severe FM pay more than those without mild and moderate - that is pretty obvious. cmon, can we not spend our research money on better studies like trying to pin down the actual pathology/dysfunction of this disease so we can better treat it as right now current treatment is pathetic